BACKGROUND: We aimed to evaluate the ability of the lactate/albumin ratio to predict mortality in pediatric septic shock patients.METHODS: Retrospective analysis of the medical records of a pediatric intensive care unit. The study cohort comprised 90 pediatric septic shock patients admitted from February 2012 to May 2015.RESULTS: The serum lactate and albumin levels and lactate/albumin ratio were compared between survivors and non-survivors. We assessed whether the lactate/albumin ratio could be used to predict mortality. The 28-day hospital mortality was 26.7%(24/90). The lactate level was higher(2.5 ± 2.2 vs 8.1 ± 5.1 mmol/L, p<0.001) and the albumin level was lower(2.9 ± 0.5 vs 2.7 ± 0.5 mg/dL, p=0.063) in non-survivors than in survivors. The lactate/albumin ratio was 0.9 ± 0.8 in survivors and 3.2 ± 2.4 in non-survivors(p<0.001). According to the area under the receiver operating characteristic curve (AUC), the lactate/albumin ratio showed good discriminatory power for predicting mortality (AUC = 0.867). A lactate/albumin ratio exceeding 1.016 led to an 7.636-fold increase in mortality.CONCLUSIONS: The lactate/albumin ratio is a useful predictor of mortality in pediatric septic shock patients.